If you are experiencing psychological symptoms of agoraphobia, such as fearing that a panic attack will make you look stupid or embarrassed in front of others, your GP may refer you to a psychiatrist (a mental health specialist).
However, if you are experiencing physical symptoms, such as a rapid heart beat, shortness of breath and feeling sick, your GP may examine you to see if there is an underlying physical cause.
Referral to a psychiatrist
If you are referred to a psychiatrist, they will ask you some questions about your symptoms, your feelings and your general background. They will want to determine whether your agoraphobia is being caused by another mental health condition. If it is, it will need to be addressed first in order to successfully treat the symptoms of agoraphobia.
For example, some patients have obsessive compulsive disorder (OCD), which is a long-term mental health condition where a person has obsessive thoughts and compulsive behaviour, such as cleaning all the time. People with OCD may avoid crowds, not because they have agoraphobia but because they are afraid of catching other people's germs.
Alternatively, someone with a social phobia may avoid leaving the house because they are afraid that they will embarrass themselves in a social situation.
DSM-IV diagnostic criteria for agoraphobia
The main criteria used to diagnose agoraphobia is the DSM-IV diagnostic criteria for agoraphobia. Under this criteria, a person is thought to have agoraphobia if:
- They are anxious about being in a place or situation, such as being in a crowd or riding on a bus, where escape or help may be difficult in the event of a panic attack or panic-like symptoms.
- They avoid the situations described above, or endure them with extreme anxiety, or with the help of a companion.
- There is no other underlying condition, such as OCD, that may explain their symptoms.
Some psychiatrists and psychologists think that this criteria is too narrow to comprehensively define agoraphobia. They feel that it does not take into account the people with agoraphobia who do not have other symptoms of panic disorder, such as those who have never had a history of panic attacks, and those whose agoraphobia is motivated by fears that are not associated with panic attacks.
However, panic attacks and panic disorder do not have to be present in order to confirm a diagnosis of agoraphobia and treatment for the condition remains largely the same, no matter which diagnostic tool is used.
